1001. Impact of the Verigene Rapid Diagnostic Blood Test as an Antibiotic Stewardship Tool amongst Hospitalized Patients in a Community Healthcare System
Session: Poster Abstract Session: Antibiotic Stewardship: General Acute Care Implementation and Outcomes
Friday, October 28, 2016
Room: Poster Hall
Posters
  • Verigene Antibiotic Stewardship 2016.pdf (527.7 kB)
  • Background: Rapid diagnostic testing of blood specimens is suggested in the 2016 IDSA/SHEA/PIDS Antibiotic Stewardship Program Implementation Guidelines to optimize antibiotic therapy and improve clinical outcomes. The Verigene Gram negative (BC-GN) and Gram positive (BC-GP) blood culture nucleic acid tests allow for the identification of select blood pathogens, common contaminants, and resistance genes within 2 to 2.5 h. The impact of combined BC-GN and BC-GP rapid testing on antibiotic use within a large community healthcare system has yet to be assessed.

    Methods:

    A pre- and post-interventional study was conducted following the implementation of the Verigene BC-GN and BC-GP tests at 10 hospitals within a large community healthcare system. Data regarding demographic, microbiology, Verigene test results, initial and subsequent antibiotic therapy and clinical course were retrospectively collected. The primary outcome was the mean time to appropriate antibiotics. Secondary outcomes were duration of antibiotics for contaminants, length of stay, total admission costs, pharmacy charges, development of acute kidney injury, Clostridium difficile, mortality, and 30-day readmission rates.

    Results:

    A total of 431 patients (188 pre and 243 post-Verigene) were analyzed. Mean time to appropriate antibiotics was significantly lower in the post-Verigene group (42.6 versus 60.9 h, p<0.001), as were duration of antibiotics for contaminants (19.3 vs 63.0 h, p <0.001). Thirty day readmission rates were significantly lower in the post-Verigene group (14.0% vs 23.4%, p =0.016). There was a trend toward decreased C. difficile in the post-Verigene group (2.5% vs 5.3%, p=0.052). All other outcomes were similar between groups. Subgroup analyses consisting of 1) solely Gram positive isolates and 2) solely Gram negative isolates revealed a significant difference in mean time to appropriate antibiotics with the BC-GP (41.0 vs 65.1 h, p<0.001) but a non-significant difference with the BC-GN assay (45.9 vs 54.1 h, p =0.20). However, escalation of therapy was possible for several patients based on BC-GN results.

    Conclusion: By decreasing the time to appropriate antibiotic therapy, the Verigene BC-GN and BC-GP tests can assist with antibiotic stewardship efforts in an inpatient community hospital setting.

    Christopher Fronczek, Pharm.D.1, Nicholas Piccicacco, Pharm.D.1, William Braun, Pharm.D.2, Joanna Caranante, Pharm.D.3, Jennifer Moeller, Pharm.D.4, Lynne Krop, Pharm. D.1 and Jonathan Grey, Pharm.D.5, (1)Pharmacy, Morton Plant Hospital, Clearwater, FL, (2)Pharmacy, St Anthony's Hospital, St. Petersburg, FL, (3)Pharmacy, St. Joseph's Hospital, Tampa, FL, (4)Pharmacy, St. Joseph's Hospital South, Riverview, FL, (5)Morton Plant Mease, Dunedin, FL

    Disclosures:

    C. Fronczek, None

    N. Piccicacco, None

    W. Braun, None

    J. Caranante, None

    J. Moeller, None

    L. Krop, None

    J. Grey, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.